Nebraska > Secretary Of State > Limited Liability Company

Application For Electronic Access Of Records - Nebraska

Application For Electronic Access Of Records Form. This is a Nebraska form and can be used in Limited Liability Company Secretary Of State .
 Fillable pdf Last Modified 9/14/2015
Get this form for FREE as a print-only pdf

APPLICATION FOR ELECTRONIC ACCESS OF RECORDS TO BE USED ONLY BY LIMITED LIABILITY COMPANIES PROVIDING HEALTH RELATED PROFESSIONAL SERVICES OR LICENSED BY THE BOARD OF ENGINEERS AND ARCHITECTS John A. Gale, Secretary of State Room 1301 State Capitol, P.O. Box 94608 Lincoln, NE 68509 http://www.sos.ne.gov Name of Limited Liability Company_________________________________________ Practice of_____________________________________________________________ (the professional service for which the limited liability company is organized to do business) MEMBERS OF THE LIMITED LIABILITY COMPANY This Section Must be Completed. List all members of the limited liability company who are required by Nebraska law to be licensed or certified to perform the professional services for which the limited liability company was organized (attach additional pages if needed). _____________________________________ Full Name & License # _____________________________________ Full Name & License # _____________________________________ Full Name & License # _____________________________________ Full Name & License # _____________________________________ Full Name & License # ____________________________________ Residence Street Address, City, State, Zip ____________________________________ Residence Street Address, City, State, Zip ____________________________________ Residence Street Address, City, State, Zip ____________________________________ Residence Street Address, City, State, Zip ____________________________________ Residence Street Address, City, State, Zip (over) American LegalNet, Inc. www.FormsWorkFlow.com MANAGERS OF THE LIMITED LIABILITY COMPANY This Section Must be Completed. List all managers of the limited liability company who are required by Nebraska law to be licensed or certified to perform the professional services for which the limited liability company was organized (attach additional pages if needed). _____________________________________ Full Name & License # _____________________________________ Full Name & License # _____________________________________ Full Name & License # _____________________________________ Full Name & License # _____________________________________ Full Name & License # ____________________________________ Residence Street Address, City, State, Zip ____________________________________ Residence Street Address, City, State, Zip ____________________________________ Residence Street Address, City, State, Zip ____________________________________ Residence Street Address, City, State, Zip ____________________________________ Residence Street Address, City, State, Zip PROFESSIONAL EMPLOYEES OF THE LIMITED LIABILITY COMPANY This Section Must be Completed. List all professional employees of the limited liability company who are required by Nebraska law to be licensed or certified to perform the professional services for which the limited liability company was organized (attach additional pages if needed). _____________________________________ Full Name & License # _____________________________________ Full Name & License # _____________________________________ Full Name & License # _____________________________________ Full Name & License # _____________________________________ Full Name & License # ____________________________________ Residence Street Address, City, State, Zip ____________________________________ Residence Street Address, City, State, Zip ____________________________________ Residence Street Address, City, State, Zip ____________________________________ Residence Street Address, City, State, Zip ____________________________________ Residence Street Address, City, State, Zip ____________________________________ Signature of Authorized Representative ______________________________________ Printed Name of Authorized Representative ____________________________________ Date FILING FEE: $50.00 Revised Jan. 2013 Neb. Rev. Stat. ยง 21-186 American LegalNet, Inc. www.FormsWorkFlow.com
Link/Embed this Document
URL
Embed


Popular Searches

  1. small claims
  2. eviction
  3. petition for termination of parental rights
  4. financial affidavit
  5. visitation
  6. dismissal
  7. civil cover sheet
  8. writ of execution
  9. Declaration
  10. notice of motion

Bookmark and Share